Clinical Microbiology Newsletter最新文献

英文中文

Acute appendicitis caused by Arcanobacterium haemolyticum 溶血隐杆菌引起的急性阑尾炎

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2025-01-02 DOI: 10.1016/j.clinmicnews.2024.12.001

Ismail Faiz , Abderrazak Saddari , Said Ezrari , Samir Kaddouri , Elmostafa Benaissa , Yassine BenLahlou , Mostafa Elouennass , Adil Maleb

Arcanobacterium haemolyticum is known for causing pharyngitis in young adults and skin/soft tissue infections in older and immunocompromised people. We report here the case of a 25-year-old patient admitted to the emergency room for pain in the right iliac fossa. Abdominal computed tomography (CT) scan showed acute uncomplicated appendicitis. The biological assessment revealed an inflammatory syndrome with CRP at 124 mg/L. The patient underwent an appendectomy by laparotomy. The cytobacteriological analysis of deep pus revealed an important leukocyte reaction to neutrophils, and the growth of Arcanobacterium haemolyticum in culture. Antibiotic susceptibility testing showed that the bacterium was susceptible to clindamycin, tetracycline, linezolid, and rifampicin, and resistant to penicillin G, sulfamethoxazole/trimethoprim, moxifloxacin, ciprofloxacin, and vancomycin. Most studies have shown that this bacterium is susceptible to all classes of antibiotics except sulfamethoxazole-trimethoprim, however, in our case and like certain recent studies, other resistances are emerging.

众所周知，溶血隐杆菌可引起年轻人的咽炎和老年人和免疫功能低下者的皮肤/软组织感染。我们在此报告一个25岁的病人因右髂窝疼痛而住进急诊室的病例。腹部电脑断层扫描显示急性无并发症阑尾炎。生物学评估显示124 mg/L的CRP引起炎症综合征。病人接受了剖腹手术阑尾切除术。深层脓液的细胞细菌学分析显示白细胞对中性粒细胞的重要反应，以及培养中溶血隐杆菌的生长。药敏试验结果显示，该细菌对克林霉素、四环素、利奈唑胺、利福平敏感，对青霉素G、磺胺甲恶唑/甲氧苄啶、莫西沙星、环丙沙星、万古霉素耐药。大多数研究表明，这种细菌对除磺胺甲恶唑-甲氧苄啶外的所有种类的抗生素都敏感，然而，在我们的案例中，就像最近的某些研究一样，其他耐药性正在出现。

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引用次数: 0

A fatal case of community-acquired Acinetobacter pittii necrotising fasciitis, and a review of the literature 社区获得性皮氏不动杆菌坏死性筋膜炎1例，并复习文献

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-11-28 DOI: 10.1016/j.clinmicnews.2024.11.003

Maja Johanne Søndergaard Knudsen, Peder Worning, Sarah Juel Paulsen, Anne Line Engsbro

We report a fatal case of a comorbid male in his 70s admitted for erysipelas on the right lower leg. The condition developed rapidly and during debridement, the patient was diagnosed with necrotising fasciitis (NF). A. pittii was isolated from both blood and tissue samples. Despite broad-spectrum antibiotics, hyperbaric oxygen treatment and surgical intervention, the patient died from multiple organ failure. A review was conducted with a PubMed search for case reports/cohort studies with cases of Acinetobacter NF. Twenty-three articles were identified reporting on 30 cases with NF caused by Acinetobacter sp. (Acinetobacter baumanii 83 %, A. pittii 0). Infections were polymicrobial in 57 % of cases and fatal in 47 % of cases. For cases unrelated to war, most identified patients suffered from one or more comorbidities. A. pittii should be considered an important finding in a patient with a soft skin infection, and the risk of NF should be assessed.

我们报告一个致命的情况下，合并症男性在他的70入院丹毒在右小腿。病情发展迅速，在清创期间，患者被诊断为坏死性筋膜炎（NF）。从血液和组织样本中分离出皮氏弧菌。尽管广谱抗生素、高压氧治疗和手术干预，患者还是死于多器官衰竭。通过PubMed检索与不动杆菌NF病例相关的病例报告/队列研究进行综述。本文对30例由鲍曼不动杆菌（83%）、皮氏不动杆菌（0%）引起的NF感染进行了23篇报道，其中57%的病例为多微生物感染，47%的病例死亡。对于与战争无关的病例，大多数确定的患者患有一种或多种合并症。对于软皮感染患者，应将皮囊炎视为一项重要发现，并应评估NF的风险。

引用次数: 0

Microbe snapshots: Dengue virus 微生物快照：登革热病毒

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-11-26 DOI: 10.1016/j.clinmicnews.2024.11.002

Samuel M. Goodfellow , Esther Vaugon

引用次数: 0

Peritoneal Tuberculosis: Navigating diagnostic challenges 腹膜结核：导航诊断挑战

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-11-22 DOI: 10.1016/j.clinmicnews.2024.11.001

Reanay Berezovskiy , Meher Sultana , Jason Guyotte , Daria Yunina-Distefano , Niyati Goradia , Irene E. Rossmer

Peritoneal Tuberculosis (TB) is an uncommon manifestation of a mycobacterial infection, typically observed in immunocompromised individuals and/or those residing in endemic regions. Usually, patients will contract pulmonary TB, which results in dissemination or reactivation of latent infection months to years following the initial infection. Here, we present a case of peritoneal TB diagnosed in an immunocompetent patient devoid of recent travel history and with negative pulmonary findings. This case highlights the importance of considering peritoneal TB in the differential diagnosis, even in immunocompetent individuals with no apparent risk factors, highlighting the complexity and variability of TB presentations.

腹膜结核（TB）是分枝杆菌感染的一种罕见表现，通常见于免疫功能低下的个体和/或居住在流行地区的人。通常，患者会感染肺结核，导致潜伏感染在初次感染后数月至数年传播或重新激活。在这里，我们提出一个病例腹膜结核诊断在免疫功能正常的病人没有最近的旅行史和阴性肺部发现。该病例强调了在鉴别诊断中考虑腹膜结核的重要性，即使在没有明显危险因素的免疫能力强的个体中也是如此，突出了结核病表现的复杂性和可变性。

引用次数: 0

Bilateral otitis media as an initial manifestation of disseminated tuberculosis disease in a patient with late HIV infection diagnosis 双侧中耳炎是一名晚期艾滋病毒感染患者播散性结核病的初期表现

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-11-07 DOI: 10.1016/j.clinmicnews.2024.10.004

Victoria Lobo-Antuña , Marta Lobo-Antuña , Juan Martínez-Andrés , Cristina Rodríguez-Prado , María Remedios Guna-Serrano , Atilio Navarro-Gonzales , Magdalena García-Rodríguez , Carmen Ricart-Olmos

Tuberculous otitis media is a rare form of extrapulmonary tuberculosis, often resulting in delayed diagnosis due to its nonspecific symptoms and low clinical suspicion. We present the case of a 29-year-old woman with initial symptoms of sudden speech impairment without other neurological manifestations. In the previous 3 months, the patient had consulted several times to the health care system due to bilateral otitis media, which did not improve with conventional treatments. Daily fever, diarrhea and weight loss were added to the picture. After admission to the Infectious Diseases department, she was diagnosed with advanced HIV infection and disseminated tuberculosis (TB) with pulmonary, intestinal, lymph node and otic involvement. This case underlines the complexity of diagnosing TB otitis media, especially in the context of HIV co-infection, and highlights the importance of routine HIV screening in patients with persistent, unexplained symptoms to facilitate early diagnosis and prevent complications.

结核性中耳炎是肺外结核的一种罕见形式，由于其症状无特异性且临床怀疑度较低，常常导致诊断延误。本病例是一名 29 岁女性，最初的症状是突然出现言语障碍，但没有其他神经系统表现。在过去的 3 个月中，患者因双侧中耳炎多次就诊于医疗系统，但常规治疗效果不佳。此外，患者还出现了每日发热、腹泻和体重减轻等症状。入住传染科后，她被诊断为晚期艾滋病病毒感染和播散性肺结核（TB），肺部、肠道、淋巴结和耳部均受累。该病例强调了结核性中耳炎诊断的复杂性，尤其是在合并艾滋病病毒感染的情况下，并强调了对有持续性不明症状的患者进行常规艾滋病病毒筛查以促进早期诊断和预防并发症的重要性。

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引用次数: 0

Medically important alphaviruses in the United States and how to test for them 美国医学上重要的字母病毒及其检测方法

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-11-04 DOI: 10.1016/j.clinmicnews.2024.10.003

Allison R. Eberly

Alphaviruses are arthropod-borne viruses (i.e. arboviruses) transmitted by mosquitos that are classically divided into two groups that infect humans: encephalitic and arthralgia-associated. While the encephalitic alphaviruses are primarily endemic in North and South America, alphaviruses associated with arthralgia are distributed globally. Given the overlapping clinical manifestations of alphaviruses with other arboviruses, diagnosis is dependent on both exposure history and laboratory testing. In the United States, diagnostic approaches largely rely on detection of host antibodies against these viruses via enzyme-linked immunosorbent assays (ELISAs) or indirect immunofluorescence assays (IFAs) in serum and/or cerebrospinal fluid. Positive results can be confirmed by plaque reduction neutralization testing (PRNT), which remains the reference standard method for anti-alphavirus antibody detection. Increasingly, select public health and reference laboratories are also offering molecular testing for certain alphaviruses, including chikungunya virus and Eastern equine encephalitis virus. Molecular testing, however, is most useful in acutely ill, viremic patients who present within the first week of symptom onset. There are no targeted antivirals for treatment, and prevention relies on protection from mosquito bites.

阿尔法病毒是由蚊子传播的节肢动物病毒（即虫媒病毒），通常分为两类感染人类的病毒：脑炎型和关节痛型。脑炎型阿尔巴病毒主要流行于北美和南美，而与关节痛相关的阿尔巴病毒则分布于全球。鉴于阿尔巴病毒的临床表现与其他虫媒病毒重叠，诊断取决于接触史和实验室检测。在美国，诊断方法主要依靠在血清和/或脑脊液中通过酶联免疫吸附试验（ELISA）或间接免疫荧光试验（IFA）检测宿主对这些病毒的抗体。阳性结果可通过斑块还原中和试验（PRNT）确认，该方法仍是抗阿耳巴病毒抗体检测的参考标准方法。越来越多的公共卫生实验室和参考实验室也开始提供某些阿尔巴病毒的分子检测，包括基孔肯雅病毒和东方马脑炎病毒。不过，分子检测对症状出现后第一周内出现的急性病毒血症患者最有用。目前还没有针对性的抗病毒药物用于治疗，预防措施主要是防止蚊虫叮咬。

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引用次数: 0

Current scenario and future prospect of scabies treatment: A comprehensive review 疥疮治疗的现状与前景：全面回顾

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-10-16 DOI: 10.1016/j.clinmicnews.2024.10.002

Nishan Hazra , Soutik Sarkar , Srijita Chakrabarti

Scabies is a common skin condition, cause by the mite known as Sarcoptes Scabiei. Every year, 150–200 million people worldwide suffer from scabies. Small children are most vulnerable to scabies, which is most prevalent in congested, unsanitary living environments. It can transfer both directly from person to person and indirectly through contact with contaminated things. Scabies results in a highly irritating host immunological reaction. Impetigo and other secondary bacterial skin infections might result from scratching the wounds. It was officially classified as a neglected tropical illness by the World Health Organization in 2017. This review gives an overview of all the available therapy to treat scabies, and recent advancements in the management of scabies treatment in preclinical as well as clinical trials.

疥疮是一种常见的皮肤病，由疥螨引起。全世界每年有 1.5 亿至 2 亿人患有疥疮。幼儿最容易感染疥疮，疥疮在拥挤、不卫生的生活环境中最为流行。疥疮既可以在人与人之间直接传播，也可以通过接触受污染的物品间接传播。疥疮会导致宿主产生高度刺激性的免疫反应。搔抓伤口可能会导致脓疱疮和其他继发性细菌性皮肤感染。世界卫生组织于 2017 年将其正式列为被忽视的热带疾病。本综述概述了治疗疥疮的所有可用疗法，以及临床前和临床试验中疥疮治疗管理的最新进展。

引用次数: 0

“Eye see worms on the down Loa”: A case study of microfilarial co-infection "眼见虫子下罗亚"：微丝蚴合并感染病例研究

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-10-10 DOI: 10.1016/j.clinmicnews.2024.10.001

Christopher George Kendra , Kevin Andrew Smith , Trina Trusty , Amber Ryan , Kenneth Gavina

Loa loa is an arthropod-transmitted filarial nematode, and one of four pathologically prevalent blood microfilaria associated with human infection. This case report describes an instance of a 41-year-old male diagnosed with Loa loa by peripheral blood smear and subsequently also diagnosed with Onchocerca. Here we describe the clinical course, diagnostic evaluation and treatment considerations when managing potential nematode co-infections. This case also highlights laboratory diagnosis strategies, treatment challenges, and emphasizes a differential diagnosis of chronic infections with neglected tropical infectious agents.

Loa loa 是一种节肢动物传播的丝虫，也是与人类感染有关的四种病理流行血液微丝蚴之一。本病例报告描述了一名 41 岁男性通过外周血涂片被诊断为 Loa loa，随后又被诊断为盘尾丝虫的病例。在此，我们描述了临床过程、诊断评估和治疗潜在线虫合并感染时的注意事项。本病例还强调了实验室诊断策略和治疗挑战，并强调了被忽视的热带传染病慢性感染的鉴别诊断。

引用次数: 0

General perspectives on dengue fever 关于登革热的一般观点

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-09-24 DOI: 10.1016/j.clinmicnews.2024.09.002

Oluwabunmi Bola Olajide , Joshua Seun Olajide , Olusanya Olasehinde

Dengue is the leading arboviral disease of major public health importance across the globe. Severe dengue causes bleeding and shock, and can be life threatening, terminating in death. There has been considerable success in vector territorial mapping, disease transmission process, diagnosis and molecular characterization of the virus. However, continuous sporadic outbreaks and re-emergence of dengue infections are common in recent time. Also, limited treatment options, weak host immune response in sequential infection, inadequate preventive measures in some areas and continual territorial expansion of the vectors are factors sustaining dengue transmission. In this review, we present an overview of dengue virus, disease predisposing factors, surveillance tools and control measures. In addition, we offer suggestions on future research direction to deepen the control efforts. Nonetheless, continual re-emergence of dengue requires redirection from antibody-dependent enhancement and the use of insecticides into environmentally favourable bio-control and molecular surveillance of the vector until effective vaccines are readily available.

登革热是对全球公共卫生具有重大意义的主要虫媒病毒疾病。严重的登革热会导致出血和休克，可危及生命，最终导致死亡。在病媒地域分布、疾病传播过程、诊断和病毒分子特征描述方面取得了巨大成功。然而，近来登革热的持续零星爆发和再次出现很常见。此外，治疗方案有限、宿主对连续感染的免疫反应较弱、某些地区的预防措施不足以及病媒领地的不断扩张也是登革热持续传播的因素。在这篇综述中，我们概述了登革热病毒、致病因素、监测工具和控制措施。此外，我们还就未来的研究方向提出了建议，以深化控制工作。尽管如此，登革热的持续复发要求我们从依赖抗体的强化和杀虫剂的使用转向对环境有利的生物控制和对病媒的分子监测，直到有效疫苗的出现。

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引用次数: 0

Navigating the new norm: The FDA's final rule on laboratory developed tests (LDTs) and its impact on clinical laboratory operations 驾驭新规范：美国食品和药物管理局关于实验室开发测试 (LDT) 的最终规定及其对临床实验室运作的影响

Q3 Medicine

Clinical Microbiology Newsletter

Pub Date : 2024-09-01 DOI: 10.1016/j.clinmicnews.2024.09.001

Rob E. Carpenter

On April 29, 2024, the U.S. Food and Drug Administration (FDA) issued a transformative final rule impacting the regulatory landscape for laboratory-developed tests (LDTs). This new regulation categorizes in vitro diagnostics (IVDs) used as LDTs under the same stringent oversight applied to other medical devices, thereby phasing out the agency's long-standing policy of enforcement discretion. This paper offers a concise historical overview and examines the FDA's revised regulatory framework scheduled for the next four years, examining its impact on laboratory operations in terms of safety, efficacy, and innovation. It explores how the new rule's increased compliance demands and economic implications impact laboratory operations, including economic stability, innovation, and patient safety. Also highlighted is how certain laboratories gain strategic advantages that could enhance their market stability and attract investors. The overall intent of this paper is not an in-depth analysis but instead it aims to inform stakeholders in health services about evolving laboratory standards. By doing so, it equips healthcare participants to strategically align with emerging regulatory demands, enhancing comprehension of how these changes influence healthcare delivery and laboratory procedures.

2024 年 4 月 29 日，美国食品和药物管理局 (FDA) 发布了一项具有变革意义的最终法规，对实验室开发的检测项目 (LDT) 的监管环境产生了影响。这项新法规将用作 LDT 的体外诊断 (IVD) 归入适用于其他医疗器械的同样严格的监管范围，从而逐步取消了该机构长期以来的执法自由裁量权政策。本文提供了一个简明的历史概述，并研究了 FDA 计划在未来四年修订的监管框架，探讨了其在安全性、有效性和创新性方面对实验室运营的影响。它探讨了新规则对合规性要求的提高和经济影响如何影响实验室的运营，包括经济稳定性、创新和患者安全。此外，本文还强调了某些实验室如何获得战略优势，从而增强其市场稳定性并吸引投资者。本文的总体意图不是进行深入分析，而是向医疗服务领域的利益相关者介绍不断发展的实验室标准。通过这样做，它可以使医疗保健参与者在战略上与新出现的监管要求保持一致，从而加深对这些变化如何影响医疗保健服务和实验室程序的理解。

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